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Bill

SB 521

Health Insurance - Material Changes to Provider Networks - Notification and Special Enrollment Period

2026 Regular Session Introduced by Ben Kramer

Maryland bill requiring insurers to notify members of major provider network changes and offer penalty-free plan switches to protect patient-doctor relationships.

Approved by the Governor - Chapter 650
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Bill Summary · SB 521

Legislative bill overview

SB 521 requires health insurers to notify enrollees when material changes occur to their provider networks and establishes a special enrollment period allowing affected members to switch plans without waiting for open enrollment. The bill aims to protect consumers from unexpected disruptions to their existing provider relationships.

Why is this important

Patients often choose health plans based on access to specific doctors or hospitals. When insurers remove providers mid-year without adequate notice, enrollees face the choice of changing doctors or paying out-of-network costs. This bill prevents those surprises by mandating transparency and providing escape routes from plans that have materially changed.

Potential points of contention

  • Insurer compliance costs: Health plans argue notification requirements and special enrollment administration increase operational expenses, potentially raising premiums
  • Definition of "material change": Ambiguity over what constitutes material (loss of primary care doctor vs. single specialist) could create disputes and litigation
  • Network churn incentives: Competitors may exploit special enrollment periods to poach members, destabilizing insurers' ability to manage costs through network design

Compiled from official sources — confirm details with the bill’s official record.

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